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目的探讨急性心肌梗死(AMI)患者血浆内皮素(ET)的动态变化及临床意义。方法应用放射免疫分析方法测定22例正常对照者和58例AMI患者发病后12、24、48、96 h及7 d的血浆ET水平。结果AMI患者血浆ET水平显著高于正常对照组(P<0.05),并呈现明显动态变化:发病12 h即达到峰值(127.9±24.1)ng/L,尔后逐渐下降,1周左右恢复正常。肌酸激酶同工酶(CK-MB)>100 U/L者ET为(160.8±21.3)ng/L,明显高于CK-MB≤100 U/L者(92.6±15.5)ng/L(P<0.05)。AMI患者血浆ET水平与CK-MB峰值和血清肌钙蛋白T(cTnT)水平均呈显著正相关(P<0.05和P<0.01)。心功能不全者的ET水平高于心功能正常者,且与心功能严重程度呈显著正相关(P<0.01)。结论ET在AMI发病后12 h达到峰,其升高程度与CK-MB、cTnT及心功能变化密切相关,是AMI强烈的内源性致病因子。
Objective To investigate the dynamic changes of plasma endothelin (ET) in patients with acute myocardial infarction (AMI) and its clinical significance. Methods Plasma ET levels were measured at 12, 24, 48, 96 and 7 days after onset in 22 normal controls and 58 AMI patients by radioimmunoassay. Results The level of plasma ET in patients with AMI was significantly higher than that in the control group (P <0.05). The plasma ET level in the patients with AMI was significantly increased (127.9 ± 24.1) ng / L at 12 hours after onset, then gradually decreased and returned to normal after 1 week. The level of ET was (160.8 ± 21.3) ng / L for CK-MB> 100 U / L, significantly higher than that for CK-MB≤100 U / L <0.05). There was a significant positive correlation between plasma ET level and CK-MB peak and serum cTnT level in patients with AMI (P <0.05 and P <0.01). The level of ET in patients with cardiac insufficiency was significantly higher than that in patients with normal cardiac function and positively correlated with the severity of cardiac function (P <0.01). Conclusions ET peaked at 12 h after onset of AMI. The elevated level of ET was closely related to the changes of CK-MB, cTnT and cardiac function, which was a strong endogenous factor of AMI.